Showing papers by "Eliane Gluckman published in 1981"

Natural killer cell activity in human bone marrow recipients: early reappearance of peripheral natural killer activity in graft-versus-host disease.

Abstract: Natural killer (NK) cell activity toward K562 target cells and antibody-dependent cell-mediated cytotoxicity (ADCC) toward L1210 cell sensitized with anti-L1210 antisera were sequentially tested in peripheral blood lymphocytes (PBLs) from 24 human bone marrow (BM) recipients Although consistently decreased before the transplant, NK cell activity was restored in all of the patients tested that argues for a bone marrow origin of NK progenitors in humans In patients without graft-versus-host disease (GVHD), peripheral NK cell activity remained low during the 1st month after the transplant, then rapidly increased and reached normal values usually between days 30 and 50 By contrast, peripheral ADCC appeared earlier restored (since day 13), suggesting that NK and ADCC are two distinct effector mechanisms When restored, peripheral NK cell activity remained within normal range, except in seven cases with a drastic fall in NK cell values contemporary with a severe viral infection, mainly with cytomegalovirus (CMV) NK cells are thus suggested to play an important role in the control of viral infections in these deeply immunodepressed patients In patients with acute GVHD, strikingly high NK values were observed early after the transplant, and during the 1st month a strong correlation did exist between high NK values and acute GVHD occurrence These results suggest that cells involved in GVHD mechanism are able to exert NK cell activity at some stages of their maturation The assessment of NK cell activity could be an attractive routine procedure for monitoring the prophylaxis of GVHD in human BM recipients

Bone Marrow Transplantation in Severe Aplastic Anaemia: a Survey of the European Group for Bone Marrow Transplantation (E.G.B.M.T.) *

Abstract: A survey of the results of bone marrow transplantation for severe aplastic anaemia in 13 European teams is reported. 159 questionnaires were analysed by univariate and multivariate analysis. The overall 1 year survival was 41.2%. The chance of survival was decreased by the presence of infection before grafting and by the use of female donors. The conditioning regimen did not influence survival. Graft rejection was influenced by the conditioning regimen and the sex of the donor. Graft-versus-host disease was influenced by the conditioning regimen, and the age and the sex of the recipient. This study defines prognostic indices which may be helpful in determining the likelihood of success after marrow transplantation for severe aplastic anaemia.

The lichen planus like and sclerotic phases of the graft versus host disease in man: an ultrastructural study of six cases.

Abstract: Skin biopsies from 6 patients with chronic graft-versus-host disease (GVHD) were studied ultrastructurally. The 6 patients experienced an early lichenoid phase 65-135 days after the graft and 3 of them progressed to a late sclerotic phase 200-340 days after the grafting Damage to the basal membrane and to the keratinocytes of the basal layer and low spinous layers, and presence of epidermal regenerative cells were features common to the lichenoid phase of chronic GVHD and idiopathic lichen planus. The late sclerotic phase of GVHD with persistence of basal cell injury, normal periodicity and structure of the collagen fibres and numerous active fibroblasts in the upper third of the dermis were findings that distinguished GVHD from scleroderma. Satellite cell necrosis, i.e. lymphocyte satellites of necrotic keratinocyte, was observed in the two phases of chronic GVHD. Thus at the ultrastructural level the early phase of chronic GVHD mimics lichen planus, but the late sclerotic phase is distinct from scleroderma.

[Ultrastructural similarities between the planus-like reaction of the graft versus host disease and the idiopathic lichen planus (author's transl)].

Abstract: An ultrastructural study was performed on skin biopsies of eight patients with lichenoid eruption of chronic graft-versus-host disease (GVHD). The lichenoid eruption is similar to idiopathic lichen planus with the injury of the basal cells, the distribution of the numerous colloid bodies, and the presence of regenerative cells. Lymphocytes satellites of injured keratinocytes were observed in those lichenoid eruptions, as well as in the acute phase of GVHD. The numerous mast cells in the lichenoid eruption of GVHD may be related to the connective tissue changes of the patients progressing to a late sclerotic phase of chronic GVHD.

Bone marrow transplantation in 65 patients with severe aplastic anemia.

Abstract: This articles summarizes the experience of the Hospital Saint-Louis Bone Marrow Transplantation Team of bone marrow transplantation in severe aplastic anemia. Sixty-five consecutive patients have been transplanted with an HLA identical sibling marrow. Various conditioning regimen have been used. Conditioning regimen using high dose Cyclophosphamide alone or associated with Procarbazine and anti-thymocyte globulin gave a high number of bone marrow graft rejection. Therefore, a conditioning regimen using Cyclophosphamide and total body irradiation with lung shielding has been used for the last three years. This regimen suppressed bone marrow graft rejection. The main problems remain graft versus host disease and intercurrent infections. Despite these complications, 50 per cent of the patients become long term survivors and are apparently cured of their initial disease.

[Cutaneous manifestations of graft versus host disease (author's transl)].

Abstract: Skin is a target organ for Graft v Host Reaction (GvHR). Cutaneous changes sometimes are the first symptoms for GvHR. They offer the opportunity for its early recognition. They include: -- A primarily acute phase, as red maculopapular rash, on face, palms and soles, which can spread over large areas, resembling scarlatiniform rash. Some courses have resulted in severe epidermal necrolysis similar to Lyell syndrome. -- A chronic phase, described with a variable time of onset after the acute episode. Two stages have been recognised: -- the early chronic phase has a clinical and histological picture similar to Lichen Planus, a frequent dermatosis which is thought to be the result of a chronic immune injury against epidermis. As early phase is fading, an atrophic aspect of the skin may develop, whose severe type is described as Poikiloderma. -- The late chronic phase, in which densification of dermal collagen is become the essential features. In some patients, sclerotic changes develop, which are resembling to scleroderma ones. The cutaneous manifestations of GvH Disease can be responsible for considerable morbidity, mortality and sequelles. They may serve as a biological model for several skin diseases.